Feeding frenzy: Thailand's fish spas nibble on despite health fears

The 'workers' in Bangkok's fish spas do not bite into living flesh, but eat loose bits of dead or unhealthy skin.

Spa-goers in Thailand are sidestepping potential health issues to wallow in tanks filled with flesh-eating fish.

Rather than razor-toothed piranhas, the fish are tiddlers that simply suck up dead skin -- but officials in Thailand and around the world have warned that blood in the spas' pools could pose serious hygiene problems.

However customers are continuing to patronize the fish spas, shrugging off any talk of danger.

"It is the same feeling like a mosquito biting you," said Lomporn Chintee, 27, after letting herself be nibbled in a "fish spa" on Phi Phi island.

"It tickles. I didn't know there was any health risk. But I'm not afraid. I would do it again.”

Charlie's Massage and Beauty on Khao San Road keeps thousands of fish in three rectangular, bathtub-sized aquariums. In Bangkok, British tourist Clive Helman said he was intrigued by the idea.

"I would consider having it done if the place was pretty clean looking,” he said. “There is a place on Phi Phi where you could give the fish your full body, with no clothes on. I would start with my feet, though, and perhaps then give the full body treatment a go, despite the alleged dangers."

A fish spa treatment entails sticking your limbs or torso into a big aquarium filled with lots of small fish and allowing them to tenderly assault your skin in an uninhibited feeding frenzy.

The toothless fish do not bite into living flesh. Instead they suck and devour loose bits of dead or unhealthy skin, providing an aquatic exfoliation. The fish are believed to like dead skin because it is relatively easy for them to remove, especially after softening in the water.

Devotees delight in the smoothness of their skin after spending 15 minutes or longer being nibbled while relaxing and keeping still, though the fish aren't scared away if customers jerk when they are tickled.

The fish at Charlie's Massage and Beauty aren't scared off if a person wriggles from being tickled too much.

Sounds fishy? Weigh the risks

Some fish spa fans stricken with gout, psoriasis, eczema, bunions and other ailments have insisted the fish cured them, giving rise to widespread debate and online first-person testimonies about the treatment's benefits and dangers.

Most establishments throughout the world use toothless Garra Rufa, also known as "doctor fish," though some places describe their fish as toothless carp or Cyprinion Macrostomus.

Health officials in some U.S. states, however, have closed down fish spas after warning that customers with tiny cuts or wounds have soaked themselves in the fish tanks alongside other customers who have similar hard-to-see lesions, thus creating the possibility of receiving or transmitting infectious diseases.

Britain's Health Protection Agency recently announced it was investigating the possibility of human infection from fish spa pedicures, but had no confirmed cases of disease. Infected human blood can turn a fresh water aquarium into a potential mixing vessel. Pieces of uneaten, dead or diseased skin floating in the tank during the treatment add to the risk of additional skin diseases, according to health officials.

On the U.K.-based Gout Support Forum, one man claimed his crippling gout was cured by the fish, which purportedly sucked out the protein from painful uric crystals in his big toe -- but no one was able to confirm the fish's role.

"If we see a little bit of blood, then they cannot go," says Pam, the owner of Charlie's Massage and Beauty.That said, there have been no reports of any diseases transmitted by the 4,000 or so fish spas currently operating throughout the country.

"I have had this fish tank business for one year, and use black honey fish, and keep everything very clean," said Pam, who owns Charlie's Massage and Beauty on Khao San road in Bangkok

"I can use other fish, but I like these because they are strong and easy to take care of. They eat only a little fish food. If I feed them too much, they become lazy and don't eat the peoples' skin.

"I have thousands of fish in these three tanks," she said, gesturing toward rectangular, bathtub-sized, aquariums where a cluster of foreigners were sitting on wood benches, dangling their bare legs in the lukewarm water.

"You can see the tanks have an ultraviolet light to kill any worms or anything else. I change the water every day. If I do not change the water, it will smell bad and the fish die.

"We also check the person's feet before they go in. If we see a little bit of blood, then they cannot go down into the water. Before they put their feet down, we must wash their feet first," Pam said, pointing to a plastic bucket, a pile of white wash cloths, and a smiling female assistant.

A French woman, offering her bare feet and legs to a shoal of nuzzling fish at Charlie's, said she did not know about the health warnings.

"I would like more information, because I care about this -- but when we go in the swimming pool, it is the same as being in water with other people," she said.

After being reminded that swimming pools use chlorine to kill germs -- which is impossible with the fish because otherwise they would perish -- the French woman watched the fish nibbling her and shrugged her shoulders.

"I don't care."

There have been no reports of any diseases transmitted by the estimated 4,000 fish spas in Thailand.

Matters of size

Elsewhere along Khao San Road, the slightly more homely Club Fish Gallery promises 15 minutes in its tank plus a free cocktail for 100 baht.

Some sensitive people say bigger fish can create a slightly uncomfortable feeling if they have sharp mouths. Tiny fish are preferable, but the sensation can be like nudges from needles.

Using fish for medical purposes apparently began in Turkey, where some spas claim they can cure acne, eczema and psoriasis after lengthy, repeat immersions lasting eight hours a day, for three weeks.

One legend tells of a Turkish shepherd who rested his injured foot among some fish in a thermal spring, and soon discovered he was healed.

Word spread and such treatments became increasingly popular in Turkey during the 1960s.

Today, they are big business at deluxe resort spas scattered across the globe, in addition to the cheaper treatments available in Thailand and elsewhere in Southeast Asia.

Richard S. Ehrlich is from San Francisco, California. He has reported news for international media from Asia since 1978, based in Hong Kong, New Delhi and now Bangkok.